10 Most common running injuries

Running is a weight bearing sport that involves the transfer of 3-4* bodyweight through the lower limbs with every footstrike. When we multiply this load out by the pure volume of strides made per kilometre of running, it quickly becomes apparent why injury is so prevalent in running populations!

Research suggests that per annum approx 70% of regular runners will sustain an injury that keeps them from running for more than two weeks. The purpose of this blog is to help you identify the 10 most common running complaints we see in our clinic so you can identify them early to get appropriate attention and avoid unwanted time on the sidelines.

The top 10 Running Injuries we see are:

“Research suggests that per annum up to 70% of regular runners will sustain an injury that keeps them from running for more than two weeks

1 Plantar fasciitis 

This is an over use condition of the plantar fascia which is the strong fibrous tissue which makes up the sole of the foot and plays an important role in arch support and shock absorption. It is a common condition seen in runners especially those with low or high arches as the plantar fascia is forced to work harder to try and maintain a neutral arch. Early signs are pain in the sole of the foot around the inner heel and arch, which is normally worst in the morning and after running. If you have any of these signs make sure you get on top of it ASAP by applying ice to the painful area after training, self massage by rolling a tennis ball along the arch, reduce training load and ensure your footwear is adequately cushioned and appropriate to your foot type.  Read more

2 Achilles Tendinopathy 

The Achilles is another structure which is loaded heavily by running as it connects the calf muscle to the heel. A tendinopathy occurs when the load applied to the tendon exceeds what it can withstand and can be caused by factors including an unaccustomed increase in training load, tight/weak calves, poor footwear and biomechanical deficits. Symptoms will usually have a gradual onset and present in varying degrees of severity as pain felt in the heel or lower calf during and after running, morning stiffness, local tenderness and swelling of the tendon. To avoid progression of these symptoms ensure your recovery is adequate, wear supportive footwear and make sure you are stretching your calves, particularly after training sessions. Read more

3 Calf Strain 

A strain injury is an acute tear in the muscle usually caused by a sudden acceleration or over-stretching. In runners calves are the most commonly strained muscles and there will normally be a sudden sharp pain or tearing sensation when the injury occurs either in the belly of the gastrocnemius (the larger muscle which makes up the calf) or at the musculotendinous junction. Runners can be predisposed to these injuries by inadequate warm ups, training under excessive fatigue and having tight weak calves. When these injuries occur, taking some time to rest and let the muscle repair is essential so it is better to reduce your risk by warming up with dynamic stretching and cooling down with some gentle static stretching.  Read more

4 Iliotibial Band Friction Syndrome [ITBFS]

The Iliotibial band is a common culprit of pain in runners! It is a thick fibrous band of tendon that extends along the outside length of the thigh from the pelvis to the knee. A friction syndrome can develop where the band connects into the outside of the knee joint and presents as pain at this point during a run particularly on longer runs or when running downhill. Anti-inflammatories, reducing mileage and foam rolling can help to settle the symptoms. It is a great idea for all runners to roll out their ITBs regularly to maintain mobility around the hip and knee joints and help prevent injury onset.  

5 Patellofemoral pain (Runners Knee) 

Patellofemoral pain is the term used to describe pain around the patella and is usually a result of overload in runners as a lot of force is transmitted through the knee cap when running.  Excess force builds up when the patella is not able to glide smoothly on the knee joint due to factors such as muscular imbalances around the knee and /or hip, increased mileage, downhill running or improper footwear. Taping techniques can help to better align the knee cap, rest and anti-inflammatories are good options to help ease the pain. Hip and VMO strengthening exercises, regular stretching, foam rolling and wearing supportive well cushioned running shoes are important to prevent and mange pain.  Read more

6 Patella Tendinopathy (Jumper’s Knee) 

It sometimes can be hard to differentiate between patellofemoral pain and patella tendinopathy as pain in both conditions presents on the front of the knee joint. The patella tendon attaches the kneecap to the shin and as tendinopathy suggests, it occurs when the load applied to the tendon exceeds what it can withstand. Pain is usually aggravated by jumping, running down hill or stairs and is usually tender to palpate at the tendinous attachment at the base of the patella. Icing and rest can help ease pain initially and proper rehabilitation exercises including eccentric loading is essential in long term management.  Read more

7 Sciatica 

Sciatica is more of an umbrella term rather than a specific diagnosis and refers to pain in the lower back or gluteal region which radiates down the back of the leg and is caused by irritation of the sciatic nerve. It can be caused by an issue in the lower back such as a herniated disc but in runners it is more commonly a result of ‘piriformis syndrome’. The piriformis is a deep gluteal muscle which runs from the sacrum to the thigh bone, the sciatic nerve passes immediately in front of the piriformis expect in 10% of the population in which it passes directly through the muscle. Piriformis syndrome occurs when the muscle becomes tight and impinges on the sciatic nerve causing local or referred symptoms. Regular stretching of the piriformis and surrounding gluteals can help prevent its onset and control symptoms. 

8 Shin Splints 

Shin splints is another umbrella term which encompasses any pain experienced below the knee on the front aspect of the lower leg. In runners pain is more commonly caused by medial tibial stress syndrome which is normally felt as pain along the inner border of the tibia and is understood to be caused by as stress reaction of the bone. Runners who increase their training too rapidly, train on hard surfaces/roads, have tight calves or biomechanical issues including excessive pronation may be at a higher risk of this injury. It can be managed early with simple strategies including calf stretching, icing, a reduction in training load and correction of biomechanical errors. Other less common causes of ‘shin splints’ are compartment syndrome and stress fractures which are more serious, therefore it is important to have any shin pain properly assessed by a physiotherapist especially if symptoms aren’t resolving with self treatment strategies.

9 Stitches 

The side stitch is something that almost every runner has experienced and is usually felt as a sharp, stabbing pain in the abdomen just below the ribs. It is unknown exactly what causes a stitch but there are many theories such as eating or drinking too soon before running or lack of oxygen delivery to the working muscles. As the cause is not definite it is hard to give concrete advice on prevention and management of symptoms,  however  it is definitely worth avoiding high fibre and fatty foods which are more slowly digested  2-3 hours before running, ensure your breathing pattern is diaphragmatic and warm up adequately. 

10 Ankle Sprain  

Ankle sprains are acute injuries in which ankle ligaments are over stretched during a fall on a twisted ankle and can often just be the result of ‘bad luck’ when running on uneven surfaces or trails. However the issue can become more chronic in people who have had multiple sprain injuries and develop poor stability around the joint. To best prevent ankle sprains stick to running on even surfaces, wear adequately cushioned footwear and maintain flexibility through your calves. In the event of a sprain make sure you immediately ice, rest, elevate and provide compression to the joint to reduce early inflammation. It is best to see a physiotherapist ASAP for assessment and rehabilitation as this is essential to endure sprains don’t become a reoccurring problem.